术前单疗程化疗对非小细胞肺癌细胞凋亡的影响

The effect of 1 cycle preoperative chemotherapy on NSCLC cell apoptosis

目的探讨术前单疗程化疗对ⅢA期非小细胞肺癌细胞凋亡率、增殖指数及bcl-2、bax基因表达的影响。方法 2002年1月至2004年1月,对144例ⅢA期非小细胞肺癌进行随机对照试验,术前化疗组（试验组）和单纯手术组（对照组）各72例,前者于术前化疗1个疗程,化疗结束10-14 d后接受手术;对照组直接行手术治疗。手术切除的肺癌组织应用流氏细胞学方法测定细胞凋亡率、增殖指数及bcl-2、bax基因的表达。结果试验组和对照组细胞凋亡率、增殖指数及bcl-2、bax基因表达分别为（7.40±2.39%）、（4.93±2.13）%;（24.99±7.51）%、（31.72±7.43）%;4.70±1.16、6.51±1.09;5.57±0.96、4.65±0.91,两组比较均差异有显著性（P〈0.05）。结论术前单疗程化疗能提高ⅢA期NSCLC的肿瘤细胞凋亡率,降低肿瘤细胞增殖指数,并抑制bcl-2基因（抑制凋亡的基因）的表达,促进bax基因（促进凋亡的基因）的表达,并可能降低细胞生存能力,减少癌转移灶的发生。

Objective To investigate the effect of one-cycle preoperative chemotherapy on apoptosis of stage-ⅢA non-small cell lung cancer cells and expression of bcl-2/bax gene.Methods From Jan 2002 to Jan 2004,144 patients were randomly divided into group A（preoperative chemotherapy group）and group B（control group,without preoperative chemotherapy）.The patients in group A were given 1 cycle preoperative chemotherapy,and operations were performed in 10 to 14 days after chemotherapy.The patients in group B were only operated.Apoptotic index（AI）,proliferation index（PI）and bcl-2/bax gene expression were detected with flow cytometry method.Results Apoptosis index（AI）,proliferation index（PI）,bcl-2 and bax expression of group A were（7.40±2.39）%,（24.99±7.51）%,4.70±1.16,5.57±0.96.Apoptosis index（AI）,proliferation index（PI）,bcl-2 and bax expression of group B were（4.93±2.13）%,（31.72±7.43）%,6.51±1.09,4.65±0.91.There were significant differences between the two groups.Conclusion The results demonstrate that the one-cycle preoperative chemotherapy could promote apoptosis decrease PI,inhibit Bcl-2 gene expression,promote bax gene expression decrease the viability of stage-ⅢA NSCLC cells,and may decrease metastasis.